Abstract
Objective: The purpose of this study was to investigate the risk factors linked to patient dropout from continuous positive airway pressure (CPAP) therapy for the treatment of obstructive sleep apnea syndrome (OSAS). Methods: This study included 1191 patients with OSAS at baseline assessment, who were followed for 3 years. We evaluated clinical parameters, indicators related to OSAS treatment, exercise habits and the presence of locomotive syndrome (LS). LS was evaluated by a ‘loco-check’, as established by the Japanese Orthopedic Association. The OSAS patients were categorized at baseline as belonging to an ‘LS group’ or a ‘non-LS group’, and clinical parameters were compared. Results: Eighty-six patients (7.2%) dropped out of CPAP therapy during the 3 year follow-up period. The dropout rate of the LS group was significantly higher than that of the non-LS group. Using a Cox-proportional hazard model, the LS, old age and poor compliance were determined to be significant risk factors for dropping out of CPAP therapy. The hazard ratios (95% CI) of LS, elderly people and poor CPAP compliance were 2.11 (1.31–3.48), 1.80 (1.11–2.94) and 1.61 (1.04–2.47), respectively. Conclusion: LS may be the critical risk factor for dropping out of CPAP therapy among patients with OSAS.
Highlights
Sleep apnea syndrome (SAS) is a typical disease with sleep disorders [1], and is found in 4% of adult men and 2% of women [2]
We have previously reported a high prevalence of locomotive syndrome (LS) in obstructive sleep apnea syndrome (OSAS)
In this study, we hypothesized that LS may be one of the risk factors for continuous positive airway pressure (CPAP) therapy dropout; to assess this, we evaluate the dropout rates between patients with and without LS using a survival analysis
Summary
Sleep apnea syndrome (SAS) is a typical disease with sleep disorders [1], and is found in 4% of adult men and 2% of women [2]. SAS is classified into either obstructive sleep apnea syndrome (OSAS). Central apnea syndrome, with OSAS representing 90% of SAS cases [3]. OSAS induces apnea due to frequent or partial upper airway obstruction during sleep, alongside gas exchange disturbance and hypoxemia. OSAS patients are two times more likely to have hypertension, two–three times more likely to have ischemic heart disease, and three–five times more likely to have cerebrovascular disease than healthy people [4]. OSAS is strongly recognized as a risk factor for lifestyle-related diseases. It has been reported to be associated with reduced health-related quality of life (HRQOL) [5]
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